How does an artificial kidney work? WAK: the artificial kidney has become a wearable device Artificial kidneys in humans for how many years.

The date: 19.07.2019

Patients suffering from acute or chronic forms renal pathologies need to support the normal functionality of the renal system and the normal excretion of urine from the body. During the period of violation of urination, the breakdown of products occurs, as a result of which intoxication occurs and all the vital systems of the body fail. If the pathology is long and severe, and the patient does not receive proper treatment, a fatal outcome may occur. For the normal functioning of the renal system, an artificial kidney is used to purify blood plasma. In this article we will tell you what an artificial kidney is, we will analyze its indications.

Characteristics and device of the device

The artificial kidney device performs the function of cleansing and removing toxins, harmful substances from the blood that is formed in the organ due to its severe damage. As a rule, this condition of the renal system occurs in acute or chronic renal failure. The functioning of an artificial kidney is based on a low molecular weight substance, which includes a colloidal solution. A semipermeable cellophane membrane with osmotic pressure is fixed on both sides. Thanks to the systematic course of purification with the help of an artificial kidney machine, the patient is able to live a normal and full life, And his internal organs perform all necessary processes.

For information! Treatment running forms renal pathologies are performed exclusively with the help of hemodialysis.

An artificial kidney can remove the following harmful substances from the body:

excess liquid;
methyl and ethyl products;
narcotic and pharmacological substances;
toxic substances and their compounds (arsenic, mercury, chlorine);
urea and its compounds;
creatinine and end products of chemical reactions inside muscle tissue.

Its useful to note, regular hemodialysis procedures require strict adherence to diet therapy, water regimen, the use of medications and timely examination by the attending physician. There are quite a lot of variations of the artificial kidney, the basic principle of the apparatus is in the physico-chemical phenomenon, where the ultrafiltration process takes place through a translucent membrane. The machine has a monitor and an equipment filter or dialyzer. Thanks to the built-in perfusion device, a constant movement of blood into the filter equipment (dialyzer) is performed. Additionally, the device provides timely supply and preparation of a special cleaning solution.

The basic principle of the device

Dialysate refers to substances that pass through the cellophane membrane of the device. Osmotic pressure is formed by the counter flow of dialysate and the blood to be purified.

For information! The composition and proportions of the dialysis solution are selected automatically by the device and individually based on the patient's health indicators and the form of the disease.

The main principles of operation of the equipment include:

venous insufficiency and thrombophlebitis, these pathologies cause clogging of the lumen of the vessels by a large thrombus;
violation of the process of filtration and removal of excess fluid, as a result of which puffiness is formed, thanks to dialysis, swelling of the brain is prevented;
restoration and normalization of the level of acidity of the biological fluid;
with acute and chronic insufficiency increases the concentration of nitrogenous substances in the blood system, due to osmotic pressure this figure returns to normal.

For information! Hemodialysis is successfully used in the treatment of acute alcohol intoxication.

After performing all the necessary procedures on the device, a second study of the level of urea and its compounds in the biological fluid is carried out.

Hemodialysis

Dialysis is a medical method of artificial blood purification, a method of dividing it into various chemical components and substances. Advantage this method- rapid removal of toxins and waste products from the body. The chemical principles of the procedure make it possible to perform it in a hospital or at home. The device for hemodialysis artificial kidney is filled with a solution, the composition of which is regulated and selected by the attending physician based on the physiological and individual features patient. The solution enters the device from the dispenser-reservoir, and its movement is opposite to that of the blood. If we consider the chemistry of the solution, then its composition is close to plasma.

For information! The level of electrolytes in a special solution is adjusted based on the needs of the patient.

It is worth noting that the solution includes potassium, sodium and glucose, the temperature is heated to 38 C degrees, after which the liquid is saturated with carbogen.

Machine efficiency

An artificial kidney cannot replace the physically anatomical analogue of an organ, however, this equipment is able to prolong the life of a patient and cleanse his blood of toxins and toxins. There are certain criteria and requirements for equipment:

equipment failure resistance;
high level of purification;
ease of use;
safety for the patient.

The equipment must have a certificate and all the necessary documentation for the management and management of it.

For information! According to studies, nephrologists have proved that annually in the world more than 50 thousand people need hemodialysis.

With continued use of an artificial kidney, patients can:

normalize the level of electrolytes;
maintain normal water-salt balance;
to prevent an increase in the level of creatinine and urea in the blood.

The use of such modern technology can save lives and maintain normal condition health in patients with terminal stage renal pathologies, and in the chronic stage, the hemodialysis procedure is performed for several years.

Contraindications and complications

Long-term performance of the blood purification procedure entails the following complications:

lack of a menstrual cycle;
testicular atrophy (death of testicular tissue);
sharp jumps in blood pressure;
decrease in bone density;
calcium metabolism disorders;
thrombus formation in venous shunts;
anemia;
damage to nephrons due to exposure to Teflon.

Of the contraindications, it is worth noting the excessive accumulation of toxic substances and toxins in the blood, which are not able to process the liver tissue and decompensation of the liver and heart.

Indications

An artificial kidney is prescribed in the presence of the following pathologies:

blocking urinary canals and arteries;
inflammation of the kidneys with a complete cessation of the outflow of urine;
received serious injuries;
bleeding;
cessation of blood supply;
post abortion infections.

You can learn more about the principle of operation of an artificial kidney from the video

Before starting hemodialysis, the specialist conducts full examination, appoints a laboratory test and evaluates the respiratory, cardiac and hepatic systems. Kidney cleansing is necessary for:

water and electrolyte disturbance;
a decrease in the alkaline index in the blood to 10 mcev per 1 liter;
high concentration of urea;
high serum nitrogen concentration.

Important! Hemodialysis is carried out in combination with a sparing diet therapy.

It should be noted that the hemodialysis procedure is not always able to provide, positive effect, in case of complications, the patient is offered a kidney transplant operation. Modern technologies allow not only to maintain the vital activity and health of the patient, but also make it possible to maintain the ability to work. If all the recommendations are followed and the procedures are performed in a timely manner, the patient with chronic stage diseases can live fully up to 30 years.

At healthy person the kidneys work normally, filtering wastes and liquids even in large volumes. In some cases, the body can not cope with its work and the concentration of toxins becomes extremely high. Such a state is called kidney failure.

This problem consists in the complete or partial loss of the ability of the internal organs to process and urinate. If a this problem If left untreated, a person may die from intoxication, so special procedures are carried out. In the following paragraphs of the article, the topic of hemodialysis will be covered in more detail - what is it and why do it.

Principle of operation

The concept of program hemodialysis means a special procedure, which consists in removing toxins from the blood.

For this, the efferent method and a special apparatus are used, which are called "artificial kidney".

With hemodialysis, it is possible:

remove toxins that are formed during metabolism;
restore the balance of water and electrolytes.

The procedure is mainly carried out in stationary conditions and consists in the use of an apparatus with a set of special membranes that have selective permeability. The body is cleansed by removing toxins from the blood and substances with a high molecular weight that can pass through the membrane.

Depending on its type and the type of dialysis solution, the blood can be purified from certain toxins and even some proteins. In addition, some solutions can be used to make up for the lack of minerals in the human body.

"Artificial kidney" consists of several elements:

perfusion device;
dialyzer;
apparatus for mixing and supplying dialysis solution;
monitor.

The device works with the help of a special perfusion device that helps the blood flow to the dialyzer. According to its principle of operation, it is similar to a pump. After cleansing, the device sends the blood back to the human body.

The dialyzer is the heart of the device. It is in it that a special membrane is located, which allows carrying out blood filtration.

It is a reservoir divided into two parts by a special membrane. Blood is supplied to it, and on the other hand - dialysis solution. Interacting through a membrane with a certain degree of permeability, the blood is cleansed and reintroduced into the body.

The apparatus for mixing and supplying the solution is necessary so that the blood is purified and pure dialysate is supplied to the membrane, and the dialysate with waste enters a separate reservoir.

The monitor on the device is designed to track the speed of blood flow. Normally, this indicator should be about 300-450 ml/min. If the blood flow is slow, then the duration of the procedure increases, and if it is higher, then the blood does not have time to completely clear itself.

In order to normalize the rate of blood flow or, if necessary, frequent dialysis in the human body, a special fistula(see photo).

It facilitates the connection of the device and connects the vein and artery. Its installation requires a special operation. Within six months, the fistula matures and reaches the necessary stage for dialysis.

In general, the whole procedure takes about 5-6 hours. During the session, the patient can engage in any calm activities.

The procedure must be carried out by specially trained personnel.

Types of hemodialysis

Hemodialysis is divided into several types, depending on whether the procedure is performed in a hospital or at home, as well as from the functionality of the device.

Also distinguished:

hemodialysis;
peritoneal dialysis.

In the first case, an artificial membrane is used to filter the blood, and in the second, the peritoneum is used.

By venue procedures emit hemodialysis:

at home;
outpatient;
at inpatient treatment.

Hemodialysis at home involves the purchase of a special apparatus by a person.

The outpatient procedure is carried out in the hospital on a first-come, first-served basis. three times a week, but the equipment for them is more specialized. The duration of the procedure is 4 hours.

At the same time, the person is under the control of the attending physician, who can change the settings for the rate of circulation of fluids, control the volume of blood and dialysate, as well as monitor pressure and hemoglobin levels in the blood. However, many patients do not like the need to wait and visit the clinic regularly.

Hemodialysis in inpatient treatment involves the patient being in the hospital. There are not many differences from the outpatient procedure. The advantages also include the constant supervision of a doctor, and the disadvantages are the need to be in the hospital in the inpatient department. In addition, with insufficient attention of doctors, a person can become infected with hepatitis B.

The functionality of the devices for hemodialysis are also different, so there are three types of procedures:

ordinary;
highly efficient;
high-precision.

Each method has its own characteristics depending on the type of membrane in the device. Conventional hemodialysis consists in using a device with a membrane up to 12.5 sq.m. This material allows filtering small molecules at low speed (200-300 ml/min). The whole procedure takes about 5 o'clock.

Highly effective hemodialysis is carried out using a membrane with an area of 2.2 sq.m. At the same time, the rate of blood passage increases to 350-500 ml/min. At the same time, the dialysis current is also approximately twice as high. Thus the blood is cleansed faster by 1-2 hours, and it itself is better filtered and becomes cleaner than with conventional dialysis.

High-precision hemodialysis is applied using a high sensitivity membrane. It allows you to pass not only small, but also large molecules, thereby allowing you to purify the blood from a greater number of toxic substances.

A feature of this type of procedure is the ability to penetrate through the membrane more substances from dialysis, so it is necessary to monitor its quality.

At what creatinine is it prescribed?

The main problem in which hemodialysis is prescribed is renal failure, since the procedure is necessary for such a patient and makes it possible to prolong his life. However, it is not always prescribed, but only at a certain concentration of creatinine in the blood. With indicators over 800-1000 mcol/l hemodialysis is already prescribed.

Also included in the indications are:

alcohol intoxication;
violations of the electrolyte composition of the blood;
drug overdose;
poisoning with some poisons;
hyperhydration.

With all its advantages, the procedure also has contraindications. Some of them are absolute, that is, apply hemodialysis strictly prohibited. This is:

cirrhosis of the liver;
damage to the vessels of the brain;
leukemia;
anemia;
CNS lesions;
age from 80 years (70 in the presence of diabetes);
malignant tumors;
lung diseases;
chronic form of hepatitis;
pathology peripheral vessels in the stage of decompensation;
epilepsy;
schizophrenia;
psychoses;
alcoholism;
coronary heart disease against the background of myocardial infarction already suffered;
heart failure;
addiction.

In other cases, the decision to conduct a blood purification procedure can only be taken by the attending physician:

diseases with a high risk of developing massive bleeding after the introduction of an anticoagulant;
active forms of tuberculosis.

How many years live on hemodialysis - statistics

Considering that most often regular hemodialysis is prescribed mainly for kidney failure or kidney problems, the overall life expectancy of a person has already been reduced.

If you do not replace the affected organ with a donor one, but use the “artificial kidney” directly, then life expectancy can be even about 20 years, depending on the characteristics of human health and its general condition. The maximum is 40 years.

A person who requires regular hemodialysis against the background of a weakened heart muscle is predicted to live for about 4 years.

The average life expectancy is about 6-12 years old. In this case, the patient does not die from kidney disease, but from infectious or inflammatory diseases and their consequences.

This happens as a result of the fact that the kidneys cannot fully perform their tasks and the human immunity is greatly weakened. As a result, any infection or virus can cause irreparable harm to health even with treatment.

Not every person is suitable for artificial blood purification, so a fairly high percentage of deaths occurs in the first year. If the human body functions normally for a year, then in 76% he will live for at least 5 more years, subject to all the requirements of the doctor.

Complications in hemodialysis

Since the kidneys are an important system for cleansing the body, disturbances in their functioning cause problems with the work of other internal organs. Complications may include:

arterial hypertension;
anemia;
CNS lesions;
bone diseases;
hyperkalemia.

Arterial hypertension is an increase in blood pressure. If such a problem occurs, the doctor prescribes a special diet. If the problem is not solved in a timely manner or started, then it can contribute to the development of a heart attack or stroke.

Anemia is a decrease in the concentration of red blood cells in the blood. This reduces the saturation of the body's cells with oxygen. Anemia is caused by a lack of erythropoietin, which is produced by healthy kidneys. The reason for the development of this condition is also large blood loss or lack of iron and vitamins in the diet.

Disorders in the work of the nervous system suggest a decrease in the sensitivity of the limbs. This condition can be caused by diabetes mellitus, a lack of B12, or an excess of toxins in the blood.

Bone disease occurs when kidney problems are advanced, when the body cannot get vitamins and minerals from the blood. The patient has brittle bones and severe destruction bone tissue because the kidneys cannot allow calcium to be absorbed more easily by converting vitamin D.

In addition, there is a deposition of excess calcium and phosphorus. As a result, there ulceration and inflammation.

Pericarditis is an inflammation of the pericardium, or lining of the heart. This happens when fluid accumulates around the organ, which causes a decrease in blood output and heart rate.

An increase in the concentration of calcium in the blood or hyperkalemia occurs when the diet is abandoned during hemodialysis. Its peculiarity lies precisely in reducing the consumption of this mineral with food. If the concentration of potassium in the blood increases, then this may become cause of cardiac arrest.

To prevent the development of complications, you must:

strictly follow the diet;
monitor personal hygiene;
consume a strictly limited amount of liquid;
take prescribed medications on a timely and regular basis;
inform the doctor if symptoms of complications;
undergo regular check-ups;
timely take the prescribed tests.

If all preventive measures are followed, the risk of complications is minimized.

At home - is it possible and how?

It is allowed to carry out hemodialysis at home. Requires a special device that is designed specifically for home use. Some of them are quite large, but modern models small and weigh from 4 to 7 kg and can be fixed on the body.

The advantages of the procedure at home are relative safety, since the device is used by only one person. In addition, dialysis can be carried out at any time and there is no need to correlate the schedule with the opening hours of the clinic and the doctor.

Disadvantages of home hemodialysis are the need for training loved one working with the device. At first, it is necessary to carry out the procedure under the supervision of the incoming medical worker. In addition, the cost of the device for home use is high and amounts to about 15-20 thousand dollars.

kidney transplant

Hemodialysis is prescribed for people suffering from kidney failure. Procedure cannot completely replace an organ, so the condition of the person is gradually deteriorating. In addition, the disease requires regular examinations by a doctor and visits to the hospital for the procedure.

Modern medicine allows some patients to improve their quality of life with a donor kidney transplant. The method is quite complicated and the risk of organ rejection is high. In addition, waiting for a donor organ can last for years, and after a transplant, a person will take drugs that depress the immune system until the end of his life.

Peritoneal dialysis

Peritoneal dialysis is also artificial blood purification method. But for its implementation, not an artificial material (membrane) is used, but a part of the human body or its peritoneum. She represents thin shell that covers the internal organs abdominal cavity.

The advantages of this method of dialysis are that the peritoneum, unlike the membrane, has a more selective permeability and allows substances with a higher molecular weight to pass through it. Thus, more types of toxins pass through it.

The procedure is carried out quite slowly. The dialysate itself is placed in the patient's abdominal cavity and blood is filtered through it through the vessels in the walls of the peritoneum.

The advantage of the method is its ability to be used by patients with end-stage renal disease, as well as in the absence of the possibility of installing a fistula.

For the procedure, an improved apparatus and peritoneal catheters are used, which provide high-quality drainage of the abdominal cavity. The catheter is fixed with a Dacron cuff in the subcutaneous fat. The catheter is inserted surgically.

This procedure may have some complications. The main ones include peritonitis or inflammation of the peritoneum. Other features are about the same as with standard hemodialysis.

The procedure is usually carried out while the patient is in the hospital, because requires constant medical supervision to change the dialysate and monitor the health of the patient.

Nutrition and diet

Carrying out hemodialysis provides for strict adherence to certain dietary habits. They consist in lowering the intake of products into the patient's body, which can increase the rate of endotoxin production.

The main principle of the diet is the restriction of fluid intake by the patient. Per day, his kidneys can produce from 500 to 800 ml of diuresis. However, overall weight gain must not exceed 2.5 kg. If there is an increase in fluid loss with sweat, then the amount of fluid consumed may be slightly higher.

An important feature of nutrition in chronic renal failure and acute renal failure is complete rejection of salt or its minimal use. It is allowed to eat no more than 8 g per day.

Find out the principles of treatment for acute renal failure in our article.

In addition to limiting the intake of salt and salty foods, it is necessary to limit the intake of foods rich in potassium. Their list is as follows:

bananas;
citruses;
dried fruits;
potatoes and some vegetables;
natural juices;
bran;
greenery;
oat flakes;
chocolate;
cocoa;
nuts.

If a person counts the amount of potassium consumed, then its volume per day should not exceed 2000 mg.

As in the case of potassium, you should limit the intake of foods with phosphorus (fish, cheeses, etc.).

With the above restrictions, a person should eat quite varied and receive enough protein and energy.

Adhering to a diet, it is also necessary to take into account the individual characteristics of the body, as well as follow the recommendations of the attending physician.

In case of any problems, it is necessary to contact him immediately in order to avoid deterioration of the condition.

How the process of hemodialysis is carried out, see in detail in the video:

opochke.com

What is an "artificial kidney"

The artificial kidney device is designed to purify the blood from toxic elements that accumulate in the blood due to insufficient excretory function of the organ.

The use of the device helps to normalize the electrolyte and acid-base balance, remove toxins from the body in case of poisoning, as well as excess water in case of swelling.

The provided algorithm of the device operation is based on biological processes occurring in the body. During the procedure, the volume of circulating blood remains normal, that is, it does not increase or decrease.

How the machine works

The device for hemodialysis is a device weighing up to 80 kg, which works like a pump. Blood from the patient passes through the dialyzer, where the purification process is carried out. This equipment is made up of a large number tubules that carry blood. Outside, they are bathed in dialysate. The system works according to the following principle: through the membrane from which the tubes are made, toxins and excess trace elements penetrate into the liquid, while large molecules of protein, bacteria, and blood constituents remain. The process is in accordance with the laws of diffusion and the difference in osmotic pressure.

In acute renal failure, the use of hemodialysis daily is indicated until the functions of the organ are restored or the symptoms of poisoning of the body are removed. If the form of the course of the disease is chronic, then the procedure is carried out 2-3 times a week.

The manipulation is carried out by a nephrologist in a hospital or in specialized hemodialysis centers.

Types of devices

There are two main types of devices. The first type is a cellophane membrane in the form of tubes, and the second - from plates. The plate form requires less heparin for the procedure, as well as a small amount of blood, which reduces the risk of complications in the patient. The tubular shape of the membrane makes it possible to purify the blood faster and better, since it has a large area. The device consists of three blocks.

pumps supplying heparin and pumping blood;
instruments showing pressure;
air bubble prevention device.

systems for air elimination, temperature control;
mixing devices, filtration monitoring;
dialyzer blood leak sensor.

Module 3 is a filter and a hemodialysis membrane.

The design of the device allows you to automatically control the patient's pressure, his hemoglobin level, as well as adjust the composition of the dialysis solution. Modern devices independently prepare a dialysis solution according to the patient's performance. These characteristics apply only to devices used in a hospital, the best of which are the devices of the concerns BAXTER-1550, NIPRO SURDIAL, Dialog Advanced.

There are devices that can be used outpatient settings. This is a portable artificial kidney machine that is designed to home use. Its technical capabilities are lower than those of stationary devices, but it performs the main function (blood purification). Such devices are worn on the belt and weigh up to 7 kg, they perform dialysis at any time of the day when the patient needs it. The duration of the manipulation is 3-4 hours.

The use of the device is characterized by the following features:

safety (the risk of infection is excluded);
ease of use;
manipulation at any time of the day.

These are the positive aspects of the device. The negatives include the following:

high price of the device;
control of health workers during the first sessions;
the need for training.

Despite some drawbacks in the operation of the apparatus, its use brings patients a certain freedom of movement, since blood purification can be carried out at any time without waiting in line at the hospital. A portable artificial kidney allows patients to perform simple physical work, and also performs dialysis at night.

Who should not use the device

The procedure has its contraindications. It can not be done to patients with such pathologies:

mental illness;
oncological pathologies;
leukemia or anemia;
pathology of the central nervous system;
advanced age (over 80 years);
diabetes mellitus (age after 70 years);
having more than two serious diseases.

It is impossible to carry out the procedure for patients suffering from alcoholism or drug addiction, who have active form tuberculosis, predisposed to the development of massive bleeding.

Unwanted Effects

After or during the procedure, patients may develop undesirable effects:

The appearance of complications becomes a reaction of the body to the behavior of manipulation. If the patient does not comply diet food, such side effects is getting bigger. Patients with renal insufficiency are prescribed a diet that strictly prohibits alcohol, spicy, spicy and smoked foods, limiting the intake of salt and fluids. If the rules of nutrition are violated, the patient creates an additional burden on the kidneys, since an increased amount of salt retains moisture in the body, leads to the formation of edema, increases the load on the heart muscle, and contributes to arterial hypertension.

During dialysis, calcium ions are washed out of the body, which contributes to destructive disorders in bone tissue. Erythropoietin deficiency (produced healthy kidneys) leads to a change in the composition of the blood. Pericarditis occurs due to the increased workload on the heart, since during the procedure it needs to pump a large volume of blood.

Conclusion

Renal failure requiring continuous hemodialysis is very serious illness. There are no exact statistics to determine how long a patient who is on forced blood purification will live. But nevertheless, carrying out the procedure, along with observing the rules of dietary nutrition, as well as normalizing the motor regimen, will prolong the patient's life. But how much - depends on the individual characteristics of the organism and concomitant diseases.

nefrologinfo.ru

Indications and contraindications

The procedure carried out by this device is called hemodialysis and is used in the following cases:

If the patient is diagnosed with acute or chronic renal failure.
In case of poisoning with drugs or alcohol.
In diseases that contribute to the accumulation of fluid in the body (edema of the lungs, brain, heart failure)

Appointed this procedure in cases where conservative ways treatments do not give positive results.

Despite the fact that hemodialysis is a fairly simple procedure, it still has a number of contraindications such as:

The presence of any chronic diseases.
Diseases of the nervous system.
Epilepsy.
Tuberculosis of any form.
Hepatitis.
Cirrhosis of the liver.
Oncological diseases.
Heart attacks, strokes.
Age over 70 years.

How is the device

Dialysis can be carried out both at home and in special medical centers and takes from 4-5 hours, the frequency of procedures depends on the type and complexity of the disease. Before starting, the patient passes medical examination, takes tests, measures his pressure and pulse, and also weighs him.

The device is designed to clean venous blood from toxins and toxins, it is connected to the patient's veins and with the help of a pump, the blood moves to a special membrane, and on the other hand, a dialyzer solution is supplied to cleanse it. The structure of the membrane and the composition of the dialyzer fluid directly depend on the disease of the patient and take into account the individual characteristics of his body.

People who are prescribed dialysis not as a one-time procedure, but as a treatment method, need to follow a special diet that limits:

Fluid intake.
Foods that contain large amounts of potassium and phosphorus.
Strict restriction of salt intake.

Inpatient or outpatient use of the device takes place under the guidance of medical personnel in equipped rooms.

To create a comfortable environment for patients, scientists have invented a portable device for dialysis. True, the price of this device is very high. And before using it, the patient needs to be trained.

Patients suffering from chronic renal failure very often require an organ transplant, but due to the lack of donor organs and cases of rejection of foreign organs by the patient's body, an implant replacing the kidney was invented.

Possible Complications

Due to the fact that most often the devices are used to remove fluid from the body, various side effects occur:

Decreases or rises blood pressure.
Fatigue appears.
Drowsiness.
Nausea and vomiting appear in connection with a decrease in pressure.
Headaches that are associated with pressure drops.
Cramps in the limbs.
An increase in temperature caused by infection in the body.

With what force such symptoms will manifest itself directly depends on the amount of fluid excreted from the body.

In spite of possible complications This procedure has saved many lives.

pochkizdorov.ru

general information

American inventor John Abel created the device in 1913, which is the prototype of the modern artificial kidney. The device was first used in 1944 by medical scientist William Kolf. The device for hemodialysis has a fairly voluminous size. Now, in order to undergo a blood purification procedure, a person must be in the hospital for several hours at least 2 times a week. This procedure cleanses the blood of waste by an average of 60%.

At severe violation functioning of the kidneys, sometimes they resort to artificial replacement of the main function of the organ. An artificial kidney in the future should fully replace the function of fluid excretion. It will purify the blood of harmful substances, correct a healthy balance of acidity, promote the elimination of toxic products and a sufficient outflow of excess water. But the task of such an apparatus is to purify the blood while maintaining its normal volume. Scientists are close to the greatest breakthrough in the field of bioengineering - they can create an implant that can fully replace a seriously ill organ.

general information

American inventor John Abel created the device in 1913, which is the prototype of the modern artificial kidney. The device was first used in 1944 by medical scientist William Kolf. The device for has quite voluminous dimensions. Now, in order to undergo a blood purification procedure, a person must be in the hospital for several hours at least 2 times a week. This procedure cleanses the blood of waste by an average of 60%.

Description of technology and principle of operation

The first woman who decided to test such a device on herself was a 67-year-old woman. She was ill with severe renal failure, which led to intoxication of the body. The procedure was successful. In 2007, a portable hemodialysis device was introduced. It is small in size and weighs no more than 4 kg. Doctors call this device a Wearable Artificial Kidney (WKI). For a person who suffers from severe kidney disease, you can have such a device with you at all times. If necessary, the doctor will connect it to the vein and the blood purification procedure takes place. The disadvantage of such an apparatus is that the purification is still much slower than in the stationary version. This device will be placed on the patient's belt, where pumps for pumping blood and replaceable cassettes with cleaning material will be attached.

Charles Jennings first tested a portable artificial kidney in 2004. It has been registered with the Patent Office since 2006 in the United States.

More recently, medical scientists at the University of California came out with a statement that an implantable kidney has been created. It contains many microfilters that will constantly purify the blood of a sick person. On the example of a portable portable device, this kidney implant was also tested, as a result proving its productivity. New modern technologies thrown in search of a method to create a compact device containing real cells. The implantable device must be no larger than a real organ for successful introduction into the human body.

Bioengineered kidney in humans

In 2010, scientists invented a hemodialysis implant that is the size of a kidney. It contains a bioreactor with a culture of cells that make up renal tubules. Such an implant fully replaces metabolic functions. Its work is carried out thanks to the circulation of the blood of the patient. The implant allows you to replace a diseased organ and does not require a donor healthy organ. Since 2013, the project has been resumed and developments are underway to create it using bioengineering methods.

Stages of development of an artificial kidney

Implants will solve the problem of shortage of donors.

Active development to grow cell-free implants has been successfully tested in rats. The information was published in well-known American magazines. The beginning of the cultivation of an implantable kidney was laid by experiments on the washing out of cellular tissue from a non-functioning organ. The kidney itself did not change its shape and structure, and special proteins were placed at the intercellular level, giving a signal for growth. Next, the matrix was washed with cells that were removed from the kidneys of newborn rats. They localized in empty places, occupying the necessary space and began to produce ordinary functions. Such an implantable kidney has already been transplanted into rats instead of a real organ.

This is a breakthrough in medicine, as such implants will solve the problem of shortage of donor organs. When they were created, modern nanotechnologies were used, which have long been used in microelectronics. An artificial kidney, passing blood through itself, leaves the shaped elements intact. Built-in filters with micropores, located one after another, perfectly perform filtration. Their number reaches 15 pieces. Living kidney cells are placed around the filters to provide functions that an artificial device cannot perform. Basically, these are the functions of the metabolism of useful substances and the removal of waste products from the body.

Acute or chronic renal failure can be fatal. The condition is extremely dangerous and requires immediate surgical intervention, the creation of an apparatus - an "artificial kidney" - became the only salvation for patients with a similar diagnosis. Without changing the volume of blood in the body, the hemodialysis device ensures the removal of toxic compounds, while normalizing water-salt metabolism and block the occurrence of arterial hypertension.

What is the installation

Medical experts note that when kidney failure is detected in acute stage, pulmonary edema or extensive intoxication of the body, purification is carried out through a special filter that imitates a genuine kidney membrane.

The use of the device is justified if the kidneys have ceased to cope with the function of processing blood and removing harmful substances from the body. At the same time, the amount of toxins in the human body increases, which causes the death of brain cells. This happens due to insufficient supply of oxygen to the brain.

Blood, passing through the equipment, is cleared of harmful substances:

urea and its compounds;
creatinine (product chemical compounds in muscles)
poisonous compounds of fungi and plants;
medicinal and narcotic drugs;
alcohol compounds (methyl and ethyl);
excess liquid.

The frequency and duration of the procedure depends on the stage of development of the disease, how advanced it is. As a rule, the patient needs 2-3 sessions per week, which take approximately 4-5 hours. During this time, the concentration of urea in the body is reduced by 70%, the condition of the person as a whole improves.

Hemodialysis procedure

To carry out the hemodialysis procedure using a portable device or stationary equipment in the clinic, it is necessary to prepare the patient in advance. The fact is that many hours of pumping out and pumping fluid through the patient's vessels can significantly spoil their condition. Usually, blood vessels such patients are already unhealthy, the device will increase their wear and tear at times.

To solve this problem, if the human vessels do not allow you to connect equipment without harm to them, there are several ways out:

creating a hole in the body (it is formed from an artery and a vein, its location is usually on the forearm);
sewing in a catheter (usually in the groin, the operation is performed under local anesthesia).

After carrying out this or that procedure, the patient is strictly prohibited from physical overstrain and lifting heavy objects. The advantage of a catheter sewn into the body is the possibility of its immediate use.

The measurement of pulse and pressure is considered necessary procedures, without which they are not connected to the installation. New portable devices and medical equipment are able to take readings on their own. Also, a person should measure their weight to assess the swelling of the tissues by the doctor and an approximate measurement of the volume of fluid pumped out.

Slag pollution and toxins are forced out of the body by creating excess hydrostatic pressure in the vessels. By squeezing the liquid through a semi-impermeable filter, the device completely cleans it and returns it back to the vessels, healthy.

The portable device is equipped with a small pumping station that supplies blood to a container with a filter. When it enters the reservoir, it is cleaned with a special solution and returns to the venous system without harmful impurities. After a few hours of operation of the device, the patient's blood becomes clean. The procedure is often repeated after 2-3 days. This ensures the normal functioning of a person suffering from kidney diseases.

The procedure for cleansing the kidneys using hemodialysis is prescribed to the patient if the organs have lost their functionality and work at only 10-15%. Violations are confirmed by manifestations unpleasant symptoms(vomiting, nausea, rapid fatigue, swelling). The device is able to take over part of the functions of the kidneys, while controlling a person's blood pressure and normalizing the water-salt balance. There are a number of conditions when hemodialysis is necessary:

cessation of blood supply;
severe blood loss;
severe injuries;
infections after abortion;
inflammation of the kidneys with the cessation of the outflow of urine;
blockage of the urinary arteries.

Before cleansing, the attending physician evaluates the patient's well-being, determines the functionality of the kidneys, the state of the respiratory system, liver, and heart. A prerequisite is the fulfillment laboratory research blood.

Principle of operation

The device for hemodialysis cleans the patient's venous blood from accumulated toxins and slags. To do this, the equipment must be connected to the patient's vein and artery system. With the help of a built-in pump, the blood gradually moves to the membrane, with reverse side dialysis solution is supplied for purification. The blood is cleaned with a solution of harmful substances and, already healthy, it enters back into the system.

Filling with dialysate equipment occurs strictly before the procedure. The solution is prepared in advance, taking into account the individual characteristics of the patient. The device creates a composition of distilled water and a concentrated product on its own. After the procedure, the effect of the drug is evaluated medical specialists on several indicators.

Types of equipment

The desire to improve the quality of life and not to “fall out” of the general rhythm drives all patients affected by kidney diseases. They want to work, take care of family and household chores, without being distracted for a long time. For these purposes, manufacturers have created a device - an artificial portable kidney. With the help of this device, the patient conducts cleansing in the familiar environment of his own home on his own, choosing the right time.

However, the cost of this equipment is high and unacceptable for a large percentage of people. Therefore, in the arsenal of doctors there are still varieties of devices that are used in a hospital setting.

portable device

The portable artificial kidney was developed by Western scientists and was shown to the world only 10 years ago. The main advantage of the device is its weight of 3.8 kg and portable battery operation. The equipment works at home, takes 4 hours, and the person feels much more comfortable than in a hospital.

The operation algorithm of this installation does not differ from the principle of operation of stationary equipment. The blood is purified through the membrane using a solution. Connection occurs through a fistula or catheter and does not take much time. Cleaning, if necessary, is carried out around the clock.

How much does such a device cost? Today, a portable device is still very expensive and not everyone can afford to buy it.

implantable device

Implants will soon become commonplace, due to the extensive use for patients with kidney failure, which has turned into chronic form. The dialysis unit is especially in demand due to the shortage of donor organs and the increasing incidence of rejection of "live" organs. own cells patient. This is a salvation for people suffering from incurable kidney pathologies.

Today, an American developer company is conducting equipment research in professional laboratories. The compact device will perform filtration functions, cleansing the kidneys of harmful substances, toxins and toxins. In this case, the energy necessary for the operation of the device will be generated due to the flow of blood flow. Information on how much such an installation will cost has not yet been reported.

Donor organ transplant

Chronic renal failure is treated by transplanting a donor organ from another, healthy person. This is surgical intervention when the patient's own organ is removed and replaced with a functioning kidney.
Usually, replacement therapy use on final stages the following diseases:

Donor organ transplantation can prolong the patient's life for a long time and improve the quality. It's vital necessary operation for children with congenital kidney problems, as constant hemodialysis inhibits the development of the baby.

Surgical intervention is performed only in cases where the donor organ is suitable according to the patient's parameters. Today, the percentage of organs that have not taken root is extremely high, so the development of artificial implants is considered a discovery that will allow medicine to reach a new level.

Contraindications for the procedure

Hemodialysis is necessary procedure to support the life and normal existence of a large number of people suffering from severe kidney disease. But the use of the device is not allowed for every patient, there are a number of contraindications:

severe arterial hypertension;
viral and bacterial infections in an acute form;
blood clotting disorders;
open tuberculosis.

Provided that the disease threatens the life of the patient, the artificial kidney apparatus is still connected, despite one or several contraindications at once. This decision is made to prolong the life of the patient.

The kidneys perform a very important function in the body, as they help cleanse the blood, remove excess fluid, and normalize the water-alkaline balance. The cessation of the functioning of this organ leads to intoxication of the body and death of the patient. To avoid lethal outcome and improve the well-being of a person before a transplant operation, an "artificial kidney" apparatus is used.

What is hemodialysis for?

Due to various pathologies the amount of functional renal tissue is sharply reduced. This condition is called kidney failure. There are certain factors that contribute to its occurrence, in particular, such as:

pyelonephritis;
oncological diseases;
deterioration of metabolic processes;
diseases of the hematopoietic organs.

It provokes intoxication of the body, leads to the accumulation of metabolic products and toxins in the blood, as well as insufficiently good fluid excretion.

In this case, transplantation of this organ is indicated, however, the process of waiting for a suitable donor can take a long time, so an "artificial kidney" device is used. Hemodialysis helps to prolong the life of the patient, makes it possible to maintain a normal state before the transplant, and also allows you to lead an active life.

The main types of devices

It is possible to carry out hemodialysis not only in a hospital, but also at home, as there are small devices for home use or permanent wear.

From a functional point of view, the "artificial kidney" apparatus differs only in some technical characteristics and membrane area. In addition, the level of manufacturability is of great importance, since in modern devices the solution is prepared by the equipment itself according to the available indicators.

The monitoring system is quite good and allows you to control the level of changes in pressure or hemoglobin, and then independently adjust the composition of the solution. However, this can only be done by the bulky apparatus "artificial kidney" Dialog +, as well as devices Gambra, Baxter-1550, used in a hospital. The capabilities of portable models, especially those designed to be worn on a belt, are severely limited.

Devices for a hospital

Modern medical devices for hemodialysis are a high-speed and high-precision computer designed for high-quality and continuous monitoring of the patient's condition and analysis of indicators. The "artificial kidney" apparatus "Fresenius" is considered to be a fairly good and functional device. Its main advantage is that the developers have implemented a modern software. This saves doctors from constant monitoring.

The 4008S artificial kidney machine can automatically calculate the flow rate of the solution, control the dosage, monitor the hemoglobin level, and also measure blood pressure.

Portable home appliances

Now widely produce devices designed for home use. Manufacturers of "artificial kidney" devices improve their products more and more every year, and the most modern of them are put on a belt and weigh only 4-7 kilograms. In this case, hemodialysis is performed daily, and the duration of the procedure is 2-4 hours. Many doctors consider this method the most effective, so it is very common in European countries. Despite the fact that the price of an "artificial kidney" device for home use is quite high (from 5 thousand dollars), many people prefer to use this particular type of product.

The main advantages of this method include safety, as well as ease of use. However, there are some disadvantages of the device, which include the high cost, as well as the need for medical supervision, especially at first.

Artificial kidney function

The device "artificial kidney" is used in the event that its own body loses its functionality by 85-90%. This device helps:

remove urea from the blood;
improve metabolic processes;
remove excess fluid;
control acid-base balance;
prevent the formation of blood clots.

In addition, it helps to saturate the blood with air, which improves the patient's well-being. Thanks to modern portable technology, hemodialysis can be performed at any convenient time without leaving home.

How the device works

The principle of operation of the apparatus "artificial kidney" is based on the fact that the device takes blood from the patient, purifies it and returns it back. The device consists of 3 main blocks that perform different function. The blood processing unit consists of pumps for its transportation, an air removal system, as well as sensors that allow you to monitor the level of pressure in the veins and arteries. The block for creation of solution includes system of mixing of water and a concentrate. It also includes a system for monitoring the level of filtration and detecting blood in solution. The dialyzer includes a membrane designed for hemodialysis.

According to its structure, the device can be lamellar or capillary. Plate devices are characterized by the fact that with their help it is very convenient to control the level of blood filtration, and they also reduce the risk of thrombosis.

Capillary devices are characterized by the fact that they use a membrane through which blood is supplied in one direction, and the dialysate solution is returned, ready for long-term use.

A group of scientists in 2010 developed a device that is implanted in the patient's body and successfully put it into practice. Such a device is compact and does not cause inconvenience. It works by intense blood pressure and does not require electricity.

The principle of operation of the device

The principle of operation of the device "artificial kidney" is based on the fact that it is connected to circulatory system human, blood from the venous system begins to move to the membrane. On the other side comes the dialysis solution for purification. As a result, the blood gets rid of toxins. The purified blood then flows back into the venous system.

Dialysate is prepared in advance, taking into account the characteristics of the patient and his physical condition. The system of the device independently creates a solution, using distilled water and a concentrated agent for this, according to the available parameters. After the procedure, its effectiveness is evaluated according to several parameters.

Carrying out hemodialysis on the device "artificial kidney"

Blood purification is mainly carried out 2-4 times a week. When flowing acute form disease shows its daily exercise. The process itself is controlled by a nephrologist or resuscitator and can take from 2 to 7 hours.

Hemodialysis is carried out in a hospital or outpatient clinic. Before the procedure, you need to weigh the patient to determine the amount of excess fluid that needs to be removed from the body, as well as measure the pulse and pressure. Then the patient sits in a chair, the doctor inserts a catheter into the vein and connects it to the device. The blood is sucked into the dialyzer chamber, then passed through the filtration system and returned in a purified form back to the body. The composition of the solution and its concentration are determined individually for each patient.

During hemodialysis, the patient must be in calm state and lie still. After that, the level of urea content is measured.